Study On The Correlation Between Homocysteine And Bone Mineral Density And Bone Metabolism In Middle-aged And Elderly Male Patients With T2DM

Objective:To explore the relationship between homocysteine(Hcy)and bone mineral density and bone metabolism indexes in middle-aged and elderly men with type 2diabetes mellitus(T2DM),screen the risk factors affecting bone mineral density,and provide a new idea for the early prevention and treatment of osteoporosis in middle-aged and elderly men with type 2 diabetes mellitus.Research objects and methods:A total of 120 middle-aged and elderly male patients with type 2 diabetes treated in the endocrinology department of our hospital from December 2020 to June 2022 were selected and screened by inclusion and exclusion criteria.The subjects were divided into non-osteoporosis group(n=88 cases)and osteoporosis group(n=32 cases)according to the T-value(≤-2.5SD)measured by dual-energy X-ray absorptiometry.General data(including age,disease course,height and weight)of the subjects were measured and recorded.Fasting blood glucose(FBG),glycated hemoglobin(Hb A1c),total cholesterol(TC),triglycerides(TG),calcium(Ca),phosphorus(P),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),homocysteine(Hcy),parathyroid hormone(PTH),and 25-hydroxyl group were collected for maintenance The values of protein D3[25(OH)D3],osteocalcin(OC),carboxy-terminal peptide of β-I collagen(β-CTX).The differences of general data,homocysteine and bone metabolism indexes between the osteoporosis group and the non-osteoporosis group were compared,the effects of Hcy on bone mineral density and bone metabolism indexes were studied,and the risk factors of T2 DM complicated with osteoporosis in middle-aged and elderly men were screened.Results:1.A total of 120 cases were studied,including 88 cases in the non-osteoporosis group and 32 cases in the osteoporosis group.In comparison between groups,Hcy,PTH and β-CTX in osteoporosis group were higher than those in non-osteoporosis group,and 25(OH)D3 and OC were lower than those in non-osteoporosis group,with statistical significance(P<0.05).2.By Pearson correlation analysis,Hcy level was negatively correlated with OC,25(OH)D3 and BMD(r=-0.463;r=-0.356;r=-0.558),was positively correlated with PTH and β-CTX(r=0.237;r=0.569),the differences were statistically significant(P<0.05).3.The binary Logistic regression model was established with whether osteoporosis was combined(no =0,yes =1)as the dependent variable and age,BMI,Hcy,PTH and25(OH)D3 as the covariables.It was found that Hcy(OR=1.780)and PTH(OR=2.094)levels were independent risk factors for osteoporosis in middle-aged and elderly men with type 2 diabetes,and the difference was statistically significant(P<0.05).Conclusion:(1)Plasma Hcy level is negatively correlated with bone mineral density in middle-aged and elderly men with T2 DM,which is an independent risk factor for osteoporosis.(2)Plasma Hcy level in middle-aged and elderly men with T2 DM was negatively correlated with OC and 25(OH)D3,and positively correlated with PTH and β-CTX.(3)PTH level is a risk factor for osteoporosis in middle-aged and elderly men with T2 DM.